BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuRheumatoid arthritisRA; Arthritis - rheumatoidRheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also affect other organs.Related video goes here for no-HTML5 browsers Causes The cause of RA is not known. It is an autoimmune disease. This means the immune system of the body mistakenly attacks healthy tissue.Previous imagePlay SlideshowStop SlideshowNext image / RA can occur at any age, but is more common in middle age. Women get RA more often than men.Infection, genes, and hormone changes may be linked to RA. Smoking and the gut microbiome are linked to the risk of developing the disease.It is less common than osteoarthritis (OA) which is a joint condition that occurs in many people due to wear and tear on the joints as they age.OsteoarthritisOsteoarthritis (OA) is the most common joint disorder. It is due to aging and wear and tear on a joint.ImageRead Article Now Book Mark Article Symptoms Most of the time, RA affects joints on both sides of the body equally. Fingers, wrists, knees, feet, elbows, ankles, hips and shoulders are the most commonly affected. The lower spine is usually not affected by RA.The disease often begins slowly. Early symptoms may include:Minor joint pain Stiffness FatigueFatigueFatigue is a feeling of weariness, tiredness, or lack of energy.ImageRead Article Now Book Mark Article Joint symptoms may include:Morning stiffness, which lasts more than 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour. Joint pain is often felt in the same joint on both sides of the body. Joints are often swollen. Over time, joints may lose their range of motion and may become deformed.Previous imagePlay SlideshowStop SlideshowNext image / Other symptoms include:Chest pain when taking a breath (pleurisy) PleurisyPleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.ImageRead Article Now Book Mark Article Dry eyes and mouth (Sjögren syndrome) Sjögren syndromeSjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The...ImageRead Article Now Book Mark Article Eye burning, itching, and discharge Eye burning, itching, and dischargeEye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.ImageRead Article Now Book Mark Article Nodules under the skin (most often a sign of more severe disease) NodulesSkin nodules are solid or cystic raised bumps in the skin that are wider than 0. 39 inches (in) or 1 centimeter (cm), but less than 0. 79 in (2 cm). ...ImageRead Article Now Book Mark Article Numbness, tingling, or burning in the hands and feet Numbness, tinglingNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Sleep difficultiesThe diagnosis of RA is made when:You have pain and swelling in 1 or more joints. Pain and swelling have been present for longer than 6 weeks. You have a positive test for rheumatoid factor or anti-cyclic citrullinated peptide (anti-CCP) antibody. You have an elevated erythrocytesedimentation rate (ESR) or C-reactive protein (CRP) levels. Erythrocytesedimentation rateESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...ImageRead Article Now Book Mark Article C-reactive proteinC-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation in the body. It is one of a group of proteins,...ImageRead Article Now Book Mark Article Other types of arthritis are not present.Sometimes the diagnosis of RA is made even without all of the conditions shown above if the arthritis is otherwise typical for RA.Rheumatoid Arthritis Symptoms Quiz The first symptom of rheumatoid arthritis (RA) is most often: A. Pain in the joints of the hands and feet B. Pain in the hips and shoulders C. Headache D. All of the above Correct Answer The correct answer is pain in the joints of the hands and feet. RA often starts in the small joints of the fingers and toes. As the arthritis becomes worse, the pain spreads to joints in the ankles, elbows, hips, knees, and shoulders. If you think you may be having symptoms of RA, see your doctor. RA usually develops slowly. A. True B. False Correct Answer The correct answer is true. The symptoms of RA most often begin slowly over weeks to a few months. You may notice fatigue and minor joint pain and stiffness, most likely in the morning. Over time, the symptoms can change or become more severe. Ask your doctor about ways to help control symptoms. The symptoms of RA can come and go. A. True B. False Correct Answer The correct answer is true. Some people have periods when they have no symptoms at all. These are called remissions. Then they might have periods when the symptoms are worse, called flares. Work with your doctor to figure out what might trigger your flares. Along with joint pain and swelling, RA can also cause: A. Dry eyes and mouth B. Burning or itchy eyes C. Slight fever D. Trouble sleeping E. B and C F. All of the above Correct Answer The correct answer is all of the above. Other symptoms of RA can include fatigue, nodules under the skin, loss of appetite, and numbness or tingling in the hands or feet. If you have joint pain and any of these symptoms, talk to your doctor. Everyone with RA usually has all of the symptoms. A. True B. False Correct Answer The correct answer is false. The symptoms of RA can vary widely from person to person. Your symptoms may also change day-to-day as your RA progresses. Ask your doctor about any new or unusual symptoms. People with RA usually feel best in the morning. A. True B. False Correct Answer The correct answer is false. The joint stiffness caused by RA is usually worst in the morning. This is one clue to diagnosing RA, since people with other types of arthritis usually feel less pain in the morning. RA symptoms occur in the same joint on both sides of the body. A. True B. False Correct Answer The correct answer is true. RA usually affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the joints most often affected. RA is caused by wear and tear on your joints: A. True B. False Correct Answer The correct answer is false. RA is an autoimmune disease. This means the body's immune system mistakenly attacks healthy tissue in your joints. Over time, RA can cause your joints to become deformed. This is one reason why it's important to talk to your doctor if you think you have RA. Early treatment can help prevent joint damage. RA can also affect the lungs, heart, or eyes. A. True B. False Correct Answer The correct answer is true. The inflammation that causes RA can also affect other organs, such as the lungs, heart, or eyes. Over time, RA can cause damage to these organs. Getting early treatment for RA can help reduce your risk for these problems. It's easy to diagnose RA. A. True B. False Correct Answer The correct answer is false. Early on, symptoms of RA are often similar to other bone and joint problems. Diagnosing RA can be tricky. And there's no one test for RA. To diagnose RA, your doctor will review your symptoms and may run tests to look for markers of RA. Most people with RA begin having symptoms in their 30s. A. True B. False Correct Answer The correct answer is false. Most people with RA first notice symptoms between the ages of 40 and 60. However, people of all ages can get RA. If you have any symptoms of RA, no matter what your age, see your doctor. Exams and Tests There is no test that can determine for sure whether you have RA. Most people with RA will have some abnormal test results. However, some people will have normal results for all tests.Two lab tests that are positive in most people and often help in the diagnosis are:Rheumatoid factor Rheumatoid factorRheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood.ImageRead Article Now Book Mark Article Anti-CCP antibody These tests are positive in most patients with RA. The anti-CCP antibody test is more specific for RA.Other tests that may be done include:Complete blood count (CBC) Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Metabolic panel and serum uric acid CRP CRPC-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation in the body. It is one of a group of proteins,...ImageRead Article Now Book Mark Article ESR ESRESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...ImageRead Article Now Book Mark Article Antinuclear antibody Antinuclear antibodyThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...ImageRead Article Now Book Mark Article Tests for hepatitis HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Joint x-rays Joint x-raysThis test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.ImageRead Article Now Book Mark Article Joint ultrasound or MRI MRIA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article Joint fluid analysisJoint fluid analysisSynovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.ImageRead Article Now Book Mark Article Treatment RA most often requires long-term treatment by an expert in arthritis called a rheumatologist. Treatment includes:Medicines Physical therapy Exercise Education to help you understand the nature of RA, your treatment options, and the need for regular follow-up Surgery, if requiredEarly treatment for RA with medicines called disease-modifying antirheumatic drugs (DMARDs) should be used in all patients. This will slow joint destruction and prevent deformities. The activity of the RA should be checked at regular visits to make sure the disease is under control. The goal of treatment is to stop the progression of the RA.MEDICINES Anti-inflammatory medicines: These include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and celecoxib.These medicines work very well to reduce joint swelling and inflammation, but they can have long-term side effects. Therefore, they should be taken only for a short time and in low doses when possible. Since they do not prevent joint damage if used alone, DMARDs should be used as well. Disease modifying antirheumatic drugs (DMARDs): These are often the medicines that are tried first in people with RA. They are prescribed along with rest, strengthening exercise, and anti-inflammatory drugs.Methotrexate is the most commonly used DMARD for RA. Leflunomide and hydroxychloroquine may also be used. Sulfasalazine is a medicine that is often combined with methotrexate and hydroxychloroquine (triple therapy). It may be weeks or months before you see any benefit from these medicines. These medicines may have serious side effects, so you will need frequent blood tests and other monitoring when taking them. Antimalarial medicines -- This group of medicines includes hydroxychloroquine (Plaquenil). They are most often used along with methotrexate. It may be weeks or months before you see any benefit from these medicines. Corticosteroids -- These medicines work very well to reduce joint swelling and inflammation, but they can have long-term side effects and do not prevent joint damage if used alone. Therefore, they should be taken only for a short time and in low doses when possible.Biologic DMARD agents -- These medicines are designed to affect parts of the immune system that play a role in the disease process of RA.They may be given when other medicines, usually methotrexate, have not worked. Biologic medicines are often added to methotrexate. However, because they are very expensive, insurance approval is generally required. Most of them are given either under the skin or into a vein. There are now many different types of biologic agents. Biologic and synthetic agents can be very helpful in treating RA. However, people taking these medicines must be watched closely because of uncommon, but serious adverse reactions:Infections from bacteria, viruses, and fungi Skin cancer, but not melanoma Skin reactions Allergic reactions Worsened heart failure Damage to nerves Low white blood cell countLow white blood cell countWhite blood cells (WBCs) fight infections from bacteria, viruses, fungi, and other germs. One important type of WBC is the neutrophil. These cells ...ImageRead Article Now Book Mark Article SURGERYSurgery may be needed to correct severely damaged joints. Surgery may include:Removal of the joint lining (synovectomy) SynovectomyKnee arthroscopy is surgery that uses a tiny camera to look inside your knee. Small cuts are made to insert the camera and small surgical tools into...ImageRead Article Now Book Mark Article Total joint replacement, in extreme cases, may include total knee replacement or total hip replacement. Total knee replacementKnee joint replacement is a surgery to replace a knee joint with a man-made artificial joint. The artificial joint is called a prosthesis.ImageRead Article Now Book Mark Article Total hip replacementHip joint replacement is surgery to replace all or part of the hip joint with a man-made joint. The artificial joint is called a prosthesis....ImageRead Article Now Book Mark Article PHYSICAL THERAPYRange-of-motion exercises and exercise programs prescribed by a physical therapist can delay the loss of joint function and help keep muscles strong.Sometimes, therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint movement.Other therapies that may help ease joint pain include:Joint protection techniques Heat and cold treatments Splints or orthotic devices to support and align joints Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night NUTRITIONSome people with RA may have intolerance or allergies to certain foods. A balanced nutritious diet is recommended. It may be helpful to eat foods rich in fish oils (omega-3 fatty acids). Smoking cigarettes should be stopped. Excessive alcohol should also be avoided. Support Groups More information and support for people with RA and their families can be found by taking part in an arthritis support group.Some people may benefit from taking part in an arthritis support group.Arthritis support groupThe following organizations provide more information on arthritis:American Academy of Orthopaedic Surgeons -- orthoinfo. aaos. org/en/diseases--condi...ImageRead Article Now Book Mark Article Outlook (Prognosis) Whether your RA progresses or not depends on the severity of your symptoms and your response to treatment. It is important to start the treatment as soon as possible. Regular follow up visits with a rheumatologist are needed to adjust the treatment. Permanent joint damage may occur without proper treatment. Early treatment with a three-medicine DMARD combination known as "triple therapy," or with biologic or targeted synthetic medicines can prevent joint pain and damage. Possible Complications If not well treated, RA can affect nearly every part of the body. Complications may include:Damage to the lung tissue. Increased risk of hardening of the arteries, leading to cardiovascular disease. Hardening of the arteriesAtherosclerosis, sometimes called "hardening of the arteries," occurs when fat, cholesterol, and other substances build up in the walls of arteries. ...ImageRead Article Now Book Mark Article Spinal injury when the neck bones become damaged. Inflammation of the blood vessels (rheumatoid vasculitis), which can lead to skin, nerve, heart, and brain problems. Swelling and inflammation of the outer lining of the heart (pericarditis) and of the heart muscle (myocarditis), which can lead to congestive heart failure. PericarditisPericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.ImageRead Article Now Book Mark Article MyocarditisMyocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.ImageRead Article Now Book Mark Article Congestive heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article However, these complications can be avoided with proper treatment. The treatments for RA can also cause serious side effects. Talk to your provider about the possible side effects of treatment and what to do if they occur. When to Contact a Medical Professional Contact your provider if you think you have symptoms of rheumatoid arthritis. Prevention There is no known prevention. Smoking appears to worsen RA, so it is important to avoid tobacco. Proper early treatment can help prevent further joint damage.Open ReferencesReferencesEngland BR, O'Dell JR. Treatment of rheumatoid arthritis. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 73.Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2021;73(7):924-939. PMID: 34101387 pubmed.ncbi.nlm.nih.gov/34101387/.McInnes IB. Rheumatoid arthritis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 243.AllVideoImagesTogRheumatoid arthritis - illustration Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints affected is usually symmetrical, involves the hands and other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body organs, whereas osteoarthritis is limited to the joints. Over time, both forms of arthritis can be crippling.Rheumatoid arthritisillustrationRheumatoid arthritis - illustration The affect of rheumatoid arthritis can progress to the degree that it is crippling. Deformities distinctive to late-stage rheumatoid arthritis such as ulnar deviation of the bones of the hands, or swan-neck deviation of the fingers occur because muscles and tendons on one side of the joint may overpower those on the other side, pulling the bones out of alignment.Rheumatoid arthritisillustrationRheumatoid arthritis - illustration Rheumatoid arthritis is another form of arthritis. The body's own immune system attacks a joint's synovial membrane, which secretes fluid and lines the joint. The synovium becomes inflamed, produces excess fluid, and the cartilage becomes rough and pitted. Rheumatoid arthritisillustrationRheumatoid arthritis - illustration Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints affected is usually symmetrical, involves the hands and other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body organs, whereas osteoarthritis is limited to the joints. Over time, both forms of arthritis can be crippling.Rheumatoid arthritisillustrationRheumatoid arthritis - illustration The affect of rheumatoid arthritis can progress to the degree that it is crippling. Deformities distinctive to late-stage rheumatoid arthritis such as ulnar deviation of the bones of the hands, or swan-neck deviation of the fingers occur because muscles and tendons on one side of the joint may overpower those on the other side, pulling the bones out of alignment.Rheumatoid arthritisillustrationRheumatoid arthritis - illustration Rheumatoid arthritis is another form of arthritis. The body's own immune system attacks a joint's synovial membrane, which secretes fluid and lines the joint. The synovium becomes inflamed, produces excess fluid, and the cartilage becomes rough and pitted. Rheumatoid arthritisillustrationA Closer Look Rheumatoid arthritis(Alt. Medicine)Rheumatoid arthritis - InDepth(In-Depth)Related Information Joint pain(Symptoms)Pleurisy(Condition)Anemia(Condition)Hypersensitivity vasculitis(Condition)Ulcers(Symptoms)Ankle replacement(Surgery)Elbow replacement(Surgery)Knee joint replacement(Surgery)Hip joint replacement(Surgery)ACL reconstruction - discharge (Discharge)Ankle replacement - discharge (Discharge)Elbow replacement - discharge (Discharge)Rheumatoid arthritis - InDepth(In-Depth)Anemia - InDepth(In-Depth) Review Date: 1/28/2025 Reviewed By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Rheumatoid arthritisRA; Arthritis - rheumatoidRheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also affect other organs.Related video goes here for no-HTML5 browsers Causes The cause of RA is not known. It is an autoimmune disease. This means the immune system of the body mistakenly attacks healthy tissue.Previous imagePlay SlideshowStop SlideshowNext image / RA can occur at any age, but is more common in middle age. Women get RA more often than men.Infection, genes, and hormone changes may be linked to RA. Smoking and the gut microbiome are linked to the risk of developing the disease.It is less common than osteoarthritis (OA) which is a joint condition that occurs in many people due to wear and tear on the joints as they age.OsteoarthritisOsteoarthritis (OA) is the most common joint disorder. It is due to aging and wear and tear on a joint.ImageRead Article Now Book Mark Article Symptoms Most of the time, RA affects joints on both sides of the body equally. Fingers, wrists, knees, feet, elbows, ankles, hips and shoulders are the most commonly affected. The lower spine is usually not affected by RA.The disease often begins slowly. Early symptoms may include:Minor joint pain Stiffness FatigueFatigueFatigue is a feeling of weariness, tiredness, or lack of energy.ImageRead Article Now Book Mark Article Joint symptoms may include:Morning stiffness, which lasts more than 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour. Joint pain is often felt in the same joint on both sides of the body. Joints are often swollen. Over time, joints may lose their range of motion and may become deformed.Previous imagePlay SlideshowStop SlideshowNext image / Other symptoms include:Chest pain when taking a breath (pleurisy) PleurisyPleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.ImageRead Article Now Book Mark Article Dry eyes and mouth (Sjögren syndrome) Sjögren syndromeSjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The...ImageRead Article Now Book Mark Article Eye burning, itching, and discharge Eye burning, itching, and dischargeEye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.ImageRead Article Now Book Mark Article Nodules under the skin (most often a sign of more severe disease) NodulesSkin nodules are solid or cystic raised bumps in the skin that are wider than 0. 39 inches (in) or 1 centimeter (cm), but less than 0. 79 in (2 cm). ...ImageRead Article Now Book Mark Article Numbness, tingling, or burning in the hands and feet Numbness, tinglingNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Sleep difficultiesThe diagnosis of RA is made when:You have pain and swelling in 1 or more joints. Pain and swelling have been present for longer than 6 weeks. You have a positive test for rheumatoid factor or anti-cyclic citrullinated peptide (anti-CCP) antibody. You have an elevated erythrocytesedimentation rate (ESR) or C-reactive protein (CRP) levels. Erythrocytesedimentation rateESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...ImageRead Article Now Book Mark Article C-reactive proteinC-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation in the body. It is one of a group of proteins,...ImageRead Article Now Book Mark Article Other types of arthritis are not present.Sometimes the diagnosis of RA is made even without all of the conditions shown above if the arthritis is otherwise typical for RA.Rheumatoid Arthritis Symptoms Quiz The first symptom of rheumatoid arthritis (RA) is most often: A. Pain in the joints of the hands and feet B. Pain in the hips and shoulders C. Headache D. All of the above Correct Answer The correct answer is pain in the joints of the hands and feet. RA often starts in the small joints of the fingers and toes. As the arthritis becomes worse, the pain spreads to joints in the ankles, elbows, hips, knees, and shoulders. If you think you may be having symptoms of RA, see your doctor. RA usually develops slowly. A. True B. False Correct Answer The correct answer is true. The symptoms of RA most often begin slowly over weeks to a few months. You may notice fatigue and minor joint pain and stiffness, most likely in the morning. Over time, the symptoms can change or become more severe. Ask your doctor about ways to help control symptoms. The symptoms of RA can come and go. A. True B. False Correct Answer The correct answer is true. Some people have periods when they have no symptoms at all. These are called remissions. Then they might have periods when the symptoms are worse, called flares. Work with your doctor to figure out what might trigger your flares. Along with joint pain and swelling, RA can also cause: A. Dry eyes and mouth B. Burning or itchy eyes C. Slight fever D. Trouble sleeping E. B and C F. All of the above Correct Answer The correct answer is all of the above. Other symptoms of RA can include fatigue, nodules under the skin, loss of appetite, and numbness or tingling in the hands or feet. If you have joint pain and any of these symptoms, talk to your doctor. Everyone with RA usually has all of the symptoms. A. True B. False Correct Answer The correct answer is false. The symptoms of RA can vary widely from person to person. Your symptoms may also change day-to-day as your RA progresses. Ask your doctor about any new or unusual symptoms. People with RA usually feel best in the morning. A. True B. False Correct Answer The correct answer is false. The joint stiffness caused by RA is usually worst in the morning. This is one clue to diagnosing RA, since people with other types of arthritis usually feel less pain in the morning. RA symptoms occur in the same joint on both sides of the body. A. True B. False Correct Answer The correct answer is true. RA usually affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the joints most often affected. RA is caused by wear and tear on your joints: A. True B. False Correct Answer The correct answer is false. RA is an autoimmune disease. This means the body's immune system mistakenly attacks healthy tissue in your joints. Over time, RA can cause your joints to become deformed. This is one reason why it's important to talk to your doctor if you think you have RA. Early treatment can help prevent joint damage. RA can also affect the lungs, heart, or eyes. A. True B. False Correct Answer The correct answer is true. The inflammation that causes RA can also affect other organs, such as the lungs, heart, or eyes. Over time, RA can cause damage to these organs. Getting early treatment for RA can help reduce your risk for these problems. It's easy to diagnose RA. A. True B. False Correct Answer The correct answer is false. Early on, symptoms of RA are often similar to other bone and joint problems. Diagnosing RA can be tricky. And there's no one test for RA. To diagnose RA, your doctor will review your symptoms and may run tests to look for markers of RA. Most people with RA begin having symptoms in their 30s. A. True B. False Correct Answer The correct answer is false. Most people with RA first notice symptoms between the ages of 40 and 60. However, people of all ages can get RA. If you have any symptoms of RA, no matter what your age, see your doctor. Exams and Tests There is no test that can determine for sure whether you have RA. Most people with RA will have some abnormal test results. However, some people will have normal results for all tests.Two lab tests that are positive in most people and often help in the diagnosis are:Rheumatoid factor Rheumatoid factorRheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood.ImageRead Article Now Book Mark Article Anti-CCP antibody These tests are positive in most patients with RA. The anti-CCP antibody test is more specific for RA.Other tests that may be done include:Complete blood count (CBC) Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Metabolic panel and serum uric acid CRP CRPC-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation in the body. It is one of a group of proteins,...ImageRead Article Now Book Mark Article ESR ESRESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...ImageRead Article Now Book Mark Article Antinuclear antibody Antinuclear antibodyThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...ImageRead Article Now Book Mark Article Tests for hepatitis HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Joint x-rays Joint x-raysThis test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.ImageRead Article Now Book Mark Article Joint ultrasound or MRI MRIA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article Joint fluid analysisJoint fluid analysisSynovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.ImageRead Article Now Book Mark Article Treatment RA most often requires long-term treatment by an expert in arthritis called a rheumatologist. Treatment includes:Medicines Physical therapy Exercise Education to help you understand the nature of RA, your treatment options, and the need for regular follow-up Surgery, if requiredEarly treatment for RA with medicines called disease-modifying antirheumatic drugs (DMARDs) should be used in all patients. This will slow joint destruction and prevent deformities. The activity of the RA should be checked at regular visits to make sure the disease is under control. The goal of treatment is to stop the progression of the RA.MEDICINES Anti-inflammatory medicines: These include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and celecoxib.These medicines work very well to reduce joint swelling and inflammation, but they can have long-term side effects. Therefore, they should be taken only for a short time and in low doses when possible. Since they do not prevent joint damage if used alone, DMARDs should be used as well. Disease modifying antirheumatic drugs (DMARDs): These are often the medicines that are tried first in people with RA. They are prescribed along with rest, strengthening exercise, and anti-inflammatory drugs.Methotrexate is the most commonly used DMARD for RA. Leflunomide and hydroxychloroquine may also be used. Sulfasalazine is a medicine that is often combined with methotrexate and hydroxychloroquine (triple therapy). It may be weeks or months before you see any benefit from these medicines. These medicines may have serious side effects, so you will need frequent blood tests and other monitoring when taking them. Antimalarial medicines -- This group of medicines includes hydroxychloroquine (Plaquenil). They are most often used along with methotrexate. It may be weeks or months before you see any benefit from these medicines. Corticosteroids -- These medicines work very well to reduce joint swelling and inflammation, but they can have long-term side effects and do not prevent joint damage if used alone. Therefore, they should be taken only for a short time and in low doses when possible.Biologic DMARD agents -- These medicines are designed to affect parts of the immune system that play a role in the disease process of RA.They may be given when other medicines, usually methotrexate, have not worked. Biologic medicines are often added to methotrexate. However, because they are very expensive, insurance approval is generally required. Most of them are given either under the skin or into a vein. There are now many different types of biologic agents. Biologic and synthetic agents can be very helpful in treating RA. However, people taking these medicines must be watched closely because of uncommon, but serious adverse reactions:Infections from bacteria, viruses, and fungi Skin cancer, but not melanoma Skin reactions Allergic reactions Worsened heart failure Damage to nerves Low white blood cell countLow white blood cell countWhite blood cells (WBCs) fight infections from bacteria, viruses, fungi, and other germs. One important type of WBC is the neutrophil. These cells ...ImageRead Article Now Book Mark Article SURGERYSurgery may be needed to correct severely damaged joints. Surgery may include:Removal of the joint lining (synovectomy) SynovectomyKnee arthroscopy is surgery that uses a tiny camera to look inside your knee. Small cuts are made to insert the camera and small surgical tools into...ImageRead Article Now Book Mark Article Total joint replacement, in extreme cases, may include total knee replacement or total hip replacement. Total knee replacementKnee joint replacement is a surgery to replace a knee joint with a man-made artificial joint. The artificial joint is called a prosthesis.ImageRead Article Now Book Mark Article Total hip replacementHip joint replacement is surgery to replace all or part of the hip joint with a man-made joint. The artificial joint is called a prosthesis....ImageRead Article Now Book Mark Article PHYSICAL THERAPYRange-of-motion exercises and exercise programs prescribed by a physical therapist can delay the loss of joint function and help keep muscles strong.Sometimes, therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint movement.Other therapies that may help ease joint pain include:Joint protection techniques Heat and cold treatments Splints or orthotic devices to support and align joints Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night NUTRITIONSome people with RA may have intolerance or allergies to certain foods. A balanced nutritious diet is recommended. It may be helpful to eat foods rich in fish oils (omega-3 fatty acids). Smoking cigarettes should be stopped. Excessive alcohol should also be avoided. Support Groups More information and support for people with RA and their families can be found by taking part in an arthritis support group.Some people may benefit from taking part in an arthritis support group.Arthritis support groupThe following organizations provide more information on arthritis:American Academy of Orthopaedic Surgeons -- orthoinfo. aaos. org/en/diseases--condi...ImageRead Article Now Book Mark Article Outlook (Prognosis) Whether your RA progresses or not depends on the severity of your symptoms and your response to treatment. It is important to start the treatment as soon as possible. Regular follow up visits with a rheumatologist are needed to adjust the treatment. Permanent joint damage may occur without proper treatment. Early treatment with a three-medicine DMARD combination known as "triple therapy," or with biologic or targeted synthetic medicines can prevent joint pain and damage. Possible Complications If not well treated, RA can affect nearly every part of the body. Complications may include:Damage to the lung tissue. Increased risk of hardening of the arteries, leading to cardiovascular disease. Hardening of the arteriesAtherosclerosis, sometimes called "hardening of the arteries," occurs when fat, cholesterol, and other substances build up in the walls of arteries. ...ImageRead Article Now Book Mark Article Spinal injury when the neck bones become damaged. Inflammation of the blood vessels (rheumatoid vasculitis), which can lead to skin, nerve, heart, and brain problems. Swelling and inflammation of the outer lining of the heart (pericarditis) and of the heart muscle (myocarditis), which can lead to congestive heart failure. PericarditisPericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.ImageRead Article Now Book Mark Article MyocarditisMyocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.ImageRead Article Now Book Mark Article Congestive heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article However, these complications can be avoided with proper treatment. The treatments for RA can also cause serious side effects. Talk to your provider about the possible side effects of treatment and what to do if they occur. When to Contact a Medical Professional Contact your provider if you think you have symptoms of rheumatoid arthritis. Prevention There is no known prevention. Smoking appears to worsen RA, so it is important to avoid tobacco. Proper early treatment can help prevent further joint damage.Open ReferencesReferencesEngland BR, O'Dell JR. Treatment of rheumatoid arthritis. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 73.Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2021;73(7):924-939. PMID: 34101387 pubmed.ncbi.nlm.nih.gov/34101387/.McInnes IB. Rheumatoid arthritis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 243.
